Patient Registration

Please read the following documents and complete the below forms before your first visit

 

HIPAA Privacy Notice

Financial Policy

Print & Complete

 

Daulton Pt Consent Form / HIPAA

Confidential Patient Information Form

Medication Form
(2+ prescriptions)

Consent to Treat Minors

Insurances Accepted

  • Cigna

  • Anthem/ BCBS

  • Health Partners

  • ​Medica

  • Medicaid Plans

  • ​UMR

  • Medicare

  • MultiPlan

  • Preferred One

  • ​UHC

  • ​U Care

  • ​All Workers Comp Plans

 

(844) 328-5866

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1600 Maxwell Dr. Suite 7

Hudson, WI 54016, USA

©2018 by Daulton Physical Therapy and Fitness.